tick-borne-dx-physician
tick-borne-dx-physician
tick-borne-dx-physician
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24 New York City Department of Health and Mental Hygiene<br />
TULAREMIA<br />
Diagnostic Laboratory Criteria<br />
• Demonstration of four-fold change in<br />
paired sera; or<br />
• Isolation of organism from a clinical<br />
specimen; or<br />
• Detection of organism by<br />
immunoflourescence assay (IFA) test<br />
or a single elevated serum antibody<br />
titer to support diagnosis. A single<br />
antibody titer should be confirmed by<br />
either one of the methods above<br />
TREATMENT<br />
The regimens listed below are guidelines only and may need to be adjusted<br />
depending on a patient’s age, medical history, underlying health conditions,<br />
pregnancy status or allergies. Consult an infectious disease specialist for the<br />
most current treatment guidelines or for individual patient treatment decisions.<br />
AGE CATEGORY DRUG DOSAGE MAXIMUM DURATION (DAYS)<br />
Adults Streptomycin 1g IM twice daily 2g per day Minimum 10<br />
OR<br />
Gentamicin 5mg/kg IM or IV Monito serum Minimum 10<br />
daily (with desired<br />
peak serum levels<br />
of at least 5 mcg/<br />
mL)<br />
drug levels<br />
OR<br />
Ciprofloxacin 400mg IV or PO N/A 10-14<br />
twice daily<br />
OR<br />
Doxycycline 100mg IV or PO N/A 14-21<br />
twice daily<br />
Children Streptomycin 15 mg/kg IM 2 g per day Minimum 10<br />
twice daily<br />
OR<br />
Gentamicin<br />
Ciprofloxacin<br />
2.5 mg/kg IM or<br />
IV 3 times daily<br />
15 mg/kg IV or<br />
PO twice daily<br />
Monito serum Minimum 10<br />
drug levels and<br />
consult a pediatric<br />
infectious disease<br />
specialist<br />
OR<br />
1 g per day 10
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